Surgery

Surgery may be the recommended initial treatment to enhance the chances of conception in women with fibroids, ovarian cysts or endometriosis, polyps in the lining of the womb or with tubal damage. Every patient is different, and your plan of care will be based on your specific diagnosis and history.

Surgical Treatments

Endometriosis: The treatment of endometriosis depends upon its severity. If the endometriosis and symptoms are more severe, particularly if there are cycts called endometriomas in the ovary, we may recommend surgery. The treatment usually involves laparoscopy. In this procedure, a small incision is made in the abdomen and a laparoscope — a tiny camera — is used to examine the pelvic cavity. The endometriosis is then removed or ablated depending on location, severity.

Fibroids: Uterine fibroids can affect fertility and the outcome of fertility treatment depending on location, size and number. An ultrasound scan will diagnose the condition and surgery will be offered if necessary. The surgery may be an abdominal operation called myometomy or a resection /removal of fibroid distorting the uterine cavity as a vaginal procedure using a fine camera system (hysteroscopic resection).

Uterine Malformation: A septate uterus (partial or complete) is an interior wall that can divide the uterus in two (similar to a chamber in the heart). Surgery to remove the wall, or septum,may be advised because of the higher risk if miscarriage associated with sepatate uterus. . The procedure is performed vaginally with a hysteroscope with or without laparoscopic visualisation. Similarly uterine adhesions can be dealt with by a hysterscopic adesiolysis.. During this procedure, a hysteroscope (a thin telescope-like instrument) is inserted through the cervix (neck of the womb) so that the uterine cavity can be seen. Intrauterine adhesions are removed using instruments such as electrocautery or scissors under hysteroscopic guidance.

Tubal surgery

Peritubal Adhesions: Adhesions are often diagnosed and treated with laparoscopy, and may assist in sponataneous conception in some patients. The laparoscope is inserted into the abdomen through a tiny incision made within the the woman’s navel. Other instruments, such as scissors or electrocautery devices, may also be used to remove the adhesions during the surgical procedure.

Hydrosalpinges or fluid filled tubes due to severe tubal damage may need to be removed or occluded laparoscopically prior to IVF treatment to improve chances of pregnancy and live birth. This will be discussed on an individual basis.